Charge Capture Specialist | Brenner Children's Hospital "Job Details"
Winston-Salem, NC, United States
- Medical Center Blvd, Winston Salem, NC, 27157, US
09/24/2021, 11:13 AM
12/31/2021, 11:13 AM
JOB SUMMARY: Responsible for performing line item charge review of research patient encounters in the WFBH charge capture system (WakeOne). Assures the accuracy and completeness of all charges linked to research and captured in WakeOne for study sponsor or insurance/patient billing of inpatient and outpatient hospital services for research participants.
EDUCATION/EXPERIENCE: High school diploma or GED required. Medical terminology, EPIC/coding experience, and knowledge of accounts payable/receivable processes preferred. One year Business or Research Office experience in a healthcare environment preferred.
LICENSURE, CERTIFICATION, and/or REGISTRATION: N/A ESSENTIAL FUNCTIONS: 1. Performs review of all technical and professional charges generated from WakeOne and any ancillary subsystems for allocation to the research study account, insurance claim and/or patient statement to verify the accuracy of charges as they compare to the research billing intention/plan outlined in the protocol Billing Grid. 2. Identifies appropriate use of billing modifiers and other CMS requirements for billing research-related charges to federal and non-federal payors. Verifies and resolves discrepancies by utilizing the tools and resources available, e.g. WakeOne billing systems, CRMS/WISER, medical record documentation, Charge Master data, Patient Accounting/VMG Business Offices and/or contacting study personnel in the appropriate internal department. Performs remediation of charge errors discovered during WakeOne review. 3. Processes charge related corrections/additions/removals in WakeOne for both the hospital and physician billing to ensure organizational compliance with all state and federal regulations. 4. Calculates and facilitates the refunding of inappropriate reimbursement in collaboration with WFBH Financial Services. Responsible for the movement of funds and correction of fees in WakeOne. 5. Audits and reviews accounts to ensure accuracy, investigates and corrects errors, follows-up on missing account information, and resolves past due accounts. 6. Contacts guarantors regarding past due accounts, re-evaluates existing payment plans as needed when account is delinquent. Ascertains amount paid, remaining amount due on assigned study sponsor accounts, and establishes payment plan with Department. 7. Follows up with Departments to ensure proper amounts are collected, paid on accounts, and answers questions regarding account balances. 8. Identifies insurance issues that need to be forwarded and addressed by the appropriate insurance teams. Reports issues to the appropriate supervisor as needed. 9. Prioritizes job tasks, demonstrates willingness to assist Manager in the completion of special projects and daily tasks to support the Department's productivity and efficiency. 10. Demonstrates responsibility for personal development by participating in continuing education offerings. 11. Performs other related duties incidental to work described herein.
SKILLS/QUALIFICATIONS: Excellent phone etiquette and internal/external customer service skills Solid oral, written, and interpersonal communication skills Ability to type, follow directions, and complete assignments within given deadlines and to establish priorities Experience abstracting information from electronic medical records like WakeOne (EPIC) Excellent analytical and problem-solving skills Experience with Microsoft Office (Word, Excel, PowerPoint) Knowledge of CPT, HCPCs, and revenue codes WORK
ENVIRONMENT: Clean, well-lit, comfortable office environment PHYSICAL REQUIREMENTS: 0% 35% 65% to to to 35% 65% 100% N/A Activity X Standing X Walking X Sitting X Bending X Reaching with arms X Finger and hand dexterity X Talking X Hearing X Seeing Lifting, carrying, pushing and or pulling: X 20 lbs. maximum X 50 lbs. maximum X 100 lbs. maximum
Wake Forest Baptist Health and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.
This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.
Wake Forest Baptist Health (www.WakeHealth.edu) is a nationally recognized academic health system in Winston-Salem, North Carolina, with an integrated enterprise including educational and research facilities, hospitals, clinics, diagnostic centers, and other primary and specialty care facilities serving 24 counties in northwest North Carolina and southwest Virginia.
It comprises: a regional clinical system with more than 300 locations, 2,100 physicians and 1,535 acute care beds; Wake Forest School of Medicine; and Wake Forest Innovations, which promotes the commercialization of research discoveries and operates Innovation Quarter, an urban research and business park specializing in biotechnology, materials science and information technology. Wake Forest Baptist’s clinical, research and educational programs are consistently ranked among the best in the country.
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